Screening Messages for Colorectal Cancer

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Michigan State University

Disqualifiers: Non-African American, Age, Insurance, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial focuses on improving colorectal cancer screening rates among African Americans in Michigan who visit Federally Qualified Health Centers. It examines whether individuals prefer a colonoscopy or a stool-based test and if personalized messages can motivate them to complete their chosen test. Participants will receive one of three types of messages: usual care, standard messages (part of the Implementation Intention Intervention), or culturally-targeted messages (also part of the Implementation Intention Intervention). Those who haven't had a recent colorectal cancer screening and are insured by Medicaid or Medicare might be suitable for this study. As an unphased trial, the study explores new methods to increase screening rates, offering participants the chance to contribute to potentially impactful healthcare improvements.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these interventions are safe?

Research has shown that implementation intention interventions are generally safe and help people complete colorectal cancer screenings. These strategies use messages to assist individuals in planning and committing to screenings.

Studies have examined the impact of tailored messages specifically designed for African Americans on their screening rates. The goal is to encourage screenings, and no safety concerns have been reported. Similarly, researchers have studied standard implementation intention interventions for their effectiveness in increasing screening rates, with no reported safety issues.

Both types of interventions focus on messaging and encouragement, not on new medications or medical procedures. As these interventions involve communication strategies, they are safe and well-tolerated by participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Screening Messages for Colorectal Cancer trial because it explores innovative ways to boost screening rates through targeted communication. Unlike standard care, which typically involves general health communication, this trial tests culturally-targeted and standard implementation intention messages. These messages are designed to resonate more personally with participants, potentially increasing their motivation to undergo screening. By tailoring messages to individual cultural contexts, this approach could lead to higher participation in colorectal cancer screenings and early detection, which is crucial for effective treatment.

What evidence suggests that this trial's interventions could be effective for improving colorectal cancer screening rates?

This trial will compare different messaging strategies to increase colorectal cancer screening rates. Participants in one arm will receive culturally-targeted implementation intention messages. Research has shown that these messages can significantly boost screening rates among African Americans, with 73% of targeted messages increasing screening rates. Another arm will provide standard implementation intention messages, which have also proven effective; specifically, a program using these messages led to a 7.3% increase in screening rates compared to regular care. Both methods aim to increase the likelihood of people completing their screenings. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

This trial is for African Americans aged 45-72 who are patients at Federally Qualified Health Centers in Michigan, have Medicaid or Medicare, and are due for colorectal cancer screening. They must not have had a colonoscopy in the last 10 years or other screenings more recently than recommended.

Inclusion Criteria

I am covered by Medicaid or Medicare insurance.

Enrolled in a FQHC

I am African American and between 45-72 years old.

Exclusion Criteria

All who do not meet inclusion criteria.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Education and Selection

Participants learn about colonoscopy, FIT Kit, and sDNA as screening options and select a modality for their screening.

2 weeks

1 visit (in-person or virtual)

Intervention

Participants receive either usual care, standard implementation intention messages, or culturally-targeted implementation intention messages to enhance screening completion.

6 months

Follow-up

Participants are monitored for completion of the selected screening modality and assessed for attitudes and perceptions related to colorectal cancer screening.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Implementation Intention Intervention: Culturally-Targeted Message
• Implementation Intention Intervention: Standard Message

Trial Overview The study tests if colorectal cancer screening rates improve when participants choose their preferred method (colonoscopy, FIT Kit, sDNA) and receive either usual care messages or one of two interventions: a standard message or a culturally-targeted message.

How Is the Trial Designed?

Group I: Implementation Intention Intervention: Culturally-Targeted Message Experimental Treatment 1 Intervention

Participants selecting a colorectal cancer screening will receive culturally-targeted implementation intention messages in addition to the "usual care" from the FQHC.

Group II: Usual Care Message Active Control 1 Intervention

Participants selecting a colorectal cancer screening will receive "usual care" from the FQHC.

Group III: Implementation Intention Intervention: Standard Message Active Control 1 Intervention

Participants selecting a colorectal cancer screening will receive implementation intention messages in addition to the "usual care" from the FQHC.

Who Is Running the Clinical Trial?

Michigan State University

Lead Sponsor

Trials

202

Recruited

687,000+

American Cancer Society, Inc.

Collaborator

Trials

237

Recruited

110,000+

Published Research Related to This Trial

A review of 15 community-based randomized controlled trials found that 73% of interventions significantly increased colorectal cancer screening rates, particularly those using patient mailings and telephone outreach.

Tailoring information to patient preferences and considering community-level factors were key strategies that contributed to the success of these interventions in improving screening rates among multi-ethnic groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-based colorectal cancer screening trials with multi-ethnic groups: a systematic review. Morrow, JB., Dallo, FJ., Julka, M.[2021]

Mailed outreach strategies, especially those including fecal immunohistochemical tests (FIT) or guaiac-based fecal occult blood tests (gFOBT), significantly increased colorectal cancer screening adherence in low-income populations, with relative risks of 2.20 and 4.34 respectively.

Patient navigation and non-individualized education also effectively improved screening rates, while individualized education and mailed outreach with incentives did not show significant benefits, highlighting the importance of intervention design in promoting screening adherence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interventions to increase colorectal cancer screening adherence in low-income settings within the United States: A systematic review and meta-analysis. Rubin, L., Okitondo, C., Haines, L., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8330134/

Effects of Culturally Targeted Message Framing on Colorectal ... This study examined how standard and culturally targeted versions of gain and loss-framed messaging affect African Americans' colorectal cancer (CRC) screening ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06085560

Study Details | NCT06085560 | Choose It and Use ... The goal of this study is to improve use of colorectal cancer screening among screening eligible African Americans who are served by Federally Qualified ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4311575/

Implementation Intentions and Colorectal Screening The 61% of participants who received a provider recommendation for CRC screening were not more likely to complete CRC screening (50.6% completed screening among ...

4. withpower.com withpower.com/trial/screening-messages-for-colorectal-cancer-dbb36

Screening Messages for Colorectal Cancer A review of 15 community-based randomized controlled trials found that 73% of interventions significantly increased colorectal cancer screening rates, ...

5. cdc.gov cdc.gov/pcd/issues/2025/25_0025.htm

Interventions to Increase Colorectal Cancer Screening ... We performed a scoping review to describe the types and effectiveness of interventions to increase CRC screening in primarily rural settings.

6. ajpmonline.org ajpmonline.org/article/S0749-3797(14)00457-7/abstract

Implementation Intentions and Colorectal Screening The study aimed to test a theoretically based "implementation intentions" intervention for improving CRC screening among unscreened adults in ...

7. jamanetwork.com jamanetwork.com/journals/jamainternalmedicine/fullarticle/2706176

Evaluation of Interventions Intended to Increase Colorectal ... This systematic review and meta-analysis examines interventions used to increase the rates of colorectal cancer screening tests.